General Form No.
7(A)
Revised August, 1948
TIME BOOK AND PAYROLL
(State job or project on which labor was performed)
TIME ROLL
(Market time each day under proper date using
NO.
NAME
WAGES
fraction when necessary)
Occupation
1
9 10 11 12 13 14 15
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
NO. OF
RATE
DAYS
PER
WORKE
DAY
D
DEDUCTIONS
TOTAL
AMOUNT
Term
Insurance
Medicare
SIGNATURE OR
Total
Deductions
Net
Amount
RESIDENCE CERTIFICATE
Place of
THUMB MARK
NUMBER
DATE
Issue
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL
1. I HEREBY CERTIFY that each person whose name appears on
this roll rendered service as indicated and for the time stated.
2. I CERTIFY that this roll is correct, every person whose name
0.00
3. I CERTIFY on ,my official oath that I have this_________day
appears hereon rendered service for the time and at the rates stated,
of __________, ____paid in cash to each man whose name appear
under my general supervision, and I approve payments of this roll.
on the bove roll, the amount set opposite his name, he having
presented himself, established his identify, and fixed his signature\
or thumb mark on the space provided therefore. Unpaid services
are indicated by red ink through the column "Amount Paid"
Chairman, Finance and Appropriation
Principal
Superinted or Foreman In-Charge
Barangay Chairman
NOTE: - Where thumb mark is to be used in place of signature and the space available is not sufficient the thumb mark may be impressed on the back hereof with
proper indication of the corresponding laborer's number and on the corresponding line on the payroll a remark "see thumb mark on the back" should be written.
Special Disbursing Officer, Paymaster
uses of
1
2
ALT+TAB
ALT+SHIFT+TAB
Switch to the next program.
Switch to the previous program